| NPI | 1275123168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 310098) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 658316) |
| Enumeration Date | 2021-01-25 |
| Last Update Date | 2021-01-25 |